Wednesday, March 19, 2014

Leptin and Ghrelin,The Mysterious Hormones Related to Weight Management.

Leptin and Ghrelin, the mysterious hormones related to weight loss and weight gain

I am going to start this blog by saying this.

trent mozingo, dr moz, dr mozingo, chiropractor dr mozingoThe current struggles with weight loss and weight management has become a very serious topic. The health status in this country continues to plummet and every physician should be setting out to tackle the obesity epidemic.

Again, I said every physician or health advocate should be setting out to tackle this epidemic…
every direct marketing connoisseur that is out to make a quick buck and get 7000 people under them so they can get a FREE BMW or whatever, by selling some miracle product with green coffee beans, Garcinia cambogias, acai berries, fat incinerators, metabolism boosters, etc.

If you are dead set that some weight loss pill is going to give you the results you want, you should stop reading now. To fully understand weight loss, you have to detach yourself from the thinking that you just need something to help boost your metabolism or just to eat less calories.

I apologize for that rant, but this is an important subject, and I get approached about three times a week with a new miracle pill and these sales persons just refuse to listen to the truths about scientific weight management.

Weight management is a very complex subject, and if you do not try to understand biochemistry on a hormonal level, you will never fully understand it.

Weight management is not just calories in, calories out.

This blog is not designed to give you all the answers you need to lose the weight you desire. This is not a concise weight loss plan. This is just a basis of information for you to take to your health care provider to discuss your goals and hopefully they will get you on a winning program.

This blog is here to help.

I am writing about two of the most currently researched hormones in regard to weight management, Leptin and Ghrelin. These two play a vital role in the maintenance of weight and appetite. There are many more hormones involved in the process of weight management, so to get the full story of what I am discussing, you should wait for further blogs, or the release of my first book, The 5:1 Weight Loss System.

The concept of leptin and ghrelin is very complex, confusing, and maybe not fully understood by any scientific practitioner. There have been countless amounts of research of these vital hormones, and many theories have been created. Sometimes, the concept can even confuse the person writing about these two hormones. I follow Dr. Mercola and a lot of his writing is spot on. But as you can read here in an article about sleep deprivation and overweight children you will see that his writing is conflicting of itself.

There are studies that show that ghrelin is the master hormone that regulates appetite, and in bariatric surgery, the majority of the weight lost can be linked to the removal of part of the stomach, inhibiting the body’s ability to produce ghrelin by association, decreasing the person’s appetite, and helping them achieve satiety with less volume.As you can see, in Dr. Mercola’s writing, he states that when children sleep more, they have benefits like lower levels of the hormone leptin. Then, the next paragraph states that if you are sleep deprived, you have decreased production of leptin??? This sounds very conflicting, right? Well it gets worse.

Other studies that analyze the serum levels of ghrelin showed that ghrelin levels are already decreased in populations with increased body fat tissue, and increased in leaner individuals, because ghrelin is responsible for helping the body eat less and decrease weight gain. So prior to the bariatric surgery, the overall levels of ghrelin are decreased in comparison to a leaner individual who isn’t a candidate for bariatric surgery. (Huh?)

Some studies show that weight loss can spike ghrelin levels in the body, trying to encourage weight gain while another study states that regaining weight after diet induced weight loss can be seen in patients with high leptin levels and low ghrelin. (Face palm)

I can go as deep as to discuss how ghrelin and leptin are related to insulin, and studies show that ghrelin inhibit the production of insulin, which is both bad and good, and insulin increases the secretion of leptin, which again, can be bad and good. Insulin promotes weight gain, but studies show that leptin promotes weight loss. (Pull my hair out)

I have put a list of cited articles at the end of this paper. You can read through them if you want, but trust me, the more you read about these two hormones, the more confused you are going to get. Heck, I am already confused about what I just wrote to give you a brief description of the research of these two complex hormones.

trent mozingo, dr moz, chiropractor in columbus So to be clear and concise, the general rule throughout the majority of research studies and physician beliefs of ghrelin is that it is the unwanted hormone because it drives hunger, and Leptin is desired to be elevated in the blood stream, and the only real problem with leptin is that you become resistant to its affects, similar to insulin.

There is a general concept that I want you to understand about this subject...

This article is my interpretation of many clinical studies of the two complex hormones of leptin and ghrelin. You can read any amount of research and satisfy your own craving for knowledge if you wish.

You can read Dr. Mercola, Hyman, or any other physician that has read the same research and tried to make some sense out of how Leptin is GOOD, and Ghrelin is BAD and how you don’t want to become “Leptin Resistant.”

I have read many different articles about this subject, and they ALL have one very specific thing in common..

Rephrase, they have very accurate research, but the interpretations are all backwards.

Again, this is my interpretation. If you do not agree with my fundamental principles of these hormones, feel free to comment.

Chicken and egg scenario.
Ghrelin is not the enemy or the savior. Neither is leptin. These two hormones can neither be praised nor scorned, they are just trying to do their job and they each get in the way of one another.

To describe the properties of these two hormones, would take a six page article in itself, so to be short and clear, I just want you to understand the basics of these two.

Ghrelin is a hormone that is released from the stomach and is linked to the impulse of hunger. Leptin is released from fat cells and linked to the feeling of satiety or fullness. These two hormones are inhibitory of each other, meaning, when one is elevated in the body, the other is decreased. Meaning, if you have severe hunger your stomach has produced a lot of ghrelin, and this will inhibit your fat cells from releasing any leptin.
It is easy to relate to ghrelin being bad, because it promotes hunger, and it is easy to promote the praise of leptin because it shuts off hunger... SORRY, scratch that way of thinking.

The most relevant studies have been made about the two hormones, but just like any scientific experiment, you first need to have a hypothesis, then experiment to prove whether it was right or wrong. The vast majority of these studies had the principle hypothesis of how leptin is good and achieves satiety and how ghrelin is bad and makes us fat.

First, you have to look at the propaganda involved in the production of these studies. Who is going to benefit from the positive outcome of the findings. Bariatric surgical centers want you to believe that ghrelin is the devil, and if you get this surgery you will reduce the production of ghrelin and give you health. Hormone clinics want you to believe that leptin is good, but you just have a hormone imbalance that needs addressed to decrease your chances of developing leptin resistance.

I have no bias to why people gain wait, or why it is so difficult to lose it. I have no ties to any clinic other than New-Start Health Center, so I only benefit from knowing the truth, and getting positive results in regard to weight loss. I have no reason to jump on any bandwagon with physicians that write beautiful articles discussing what they have found by reading research. To me, regurgitating the information from a research study is doing nothing more than become a proponent of whoever wanted the study performed. Instead, I think outside the box, design my own opinion, with no ulterior motive, unless you consider getting unparalleled results inside of my clinic, motive.

Now I have procrastinated long enough from giving you the goods that I promised, so here goes.

Start by thinking this, ghrelin is supposed to be high, and leptin is supposed to be low in the body.

Do not concern yourself with leptin resistance, or elevated ghrelin will make you hungry and overeat. Instead understand that leptin is produced from fat cells. If you have excess fat cells, you will produce excess leptin, seem simple enough?

With each article that I have read, it is clear that when you lose weight, leptin levels drop dramatically, and ghrelin levels increase. The reason for this is that ghrelin is the master hormone regulator of your body weight, but more importantly your, LEAN BODY MASS. Your body does not want to experience any radical changes in your lean body mass because it sees this as stress on the body and will put you into starvation mode. When you are in starvation mode, your metabolism will slow down and further the problem.  Dieting often results in us under eating the adequate amount of calories, and when this happens, your starvation mode, or natural preservation, system in the body will maintain your fat cell stores of energy, and you will start to break down your muscles for energy. Unfortunately, when you see the scale moving in a downward direction, this is bad, because you are decreasing your muscle mass, decreasing your lean body mass, and decreasing your resting metabolic rate (RMR). The RMR is your body’s ability to burn calories at rest. The only way to affect this is to alter your lean body mass. As you can see, altering your RMR, or altering your lean body mass will alter your ghrelin.

So what does ghrelin want?

The average American gains weight very slowly and steadily. If you were to gain 1-4 pounds a year, the body will not register this as a major insult to the body, so what happens is ghrelin levels are reduced ever so slowly and fat content rises. With the rising fat cells, more leptin will be produced. So according to a clinical study, overweight people have a lower level of ghrelin, and a higher level of leptin in regard to leaner individuals will make sense.

Ghrelin is satisfied when your lean body mass does not change, so when you sit at a desk all day and do nothing to promote muscle mass increase, your lean body mass will stay the same. Your fat content will grow and grow, but you will have no change to your muscles or organ structures. Ghrelin levels must go down, because as I stated before, the two hormones are inhibitory of each other. If you put on fat mass, and produce more leptin, your body’s natural reaction is to decrease the release of ghrelin.

Leptin resistance is the new fad reasoning for this phenomenon of elevated levels of leptin and is compared to insulin resistance.  

I have to agree, and as promised I am going to stay on track of talking about leptin and ghrelin without soapboxing about insulin, but I have to state this.

Leptin resistance and insulin resistance are very similar. Most clinical studies of insulin resistance and Type 2 Diabetes have a very specific bias and principle that is also BACKWARDS.

There is nothing wrong with your insulin, you just have too much of it that makes you resistant. You have too much of it because you have eating too much sugar. This is the same as leptin. There is nothing wrong with your leptin that causes resistance, you just have too much of it which solidifies my principle thinking..

Start by thinking this, ghrelin is supposed to be high, and leptin is supposed to be low in the body.

Lets get back to the point.

We are all interested in how I make sense of weight loss and these two complex hormones.
Well here goes, the only way to effectively lose weight and maintain the new weight, is to satisfy my principle thinking of these two hormones, elevate ghrelin, and decrease leptin.

Maybe you need more convincing of this principle.

It is impossible to lose weight with elevated insulin levels in the body, instead you need insulin levels low and elevated glucagon levels. Glucagon is the opposite of insulin, it removed energy from fat cells instead of storing it.

Well guess what hormone inhibits the release of insulin and promotes the release of glucagon?

Ghrelin, good ole ghrelin.

So back to the principles, you want elevated ghrelin because it will inhibit the release of insulin and promote the release of the fat burning hormone, glucagon.

Elevated insulin levels increase the release of leptin. Elevated insulin inhibits glucagon. Can you see what I mean?

IF you need this in more detail, I will explain it more clearly in my book, The 5:1 Weight Loss System.

Why weight loss is not easy?

You can not just eat less, exercise, and expect to lose weight properly. Again, this concept will reduce your lean body mass and make your ghrelin levels spike to cause the yo-yo dieting effect.

It is important to stop focusing on the scale to measure your weight loss. Instead, look into fat loss, or the conversion of fat tissue into muscle tissue. Typically, on a clean diet and exercise regimen, you shouldn’t even see a loss of weight for a few weeks. Adjusting your macronutrients will allow you to start to lose fat tissue, but you have to make sure you eat adequate proteins and fats to maintain your lean body mass.

Under eating causes a whole cascade of events, including a decrease in the function of thy thyroid. You will see your body temperature drop, and you metabolic function will suffer.

In conclusion:

The main concept that I want you to take from this writing is that the common fad about weight management and the issues inhibiting weight loss are typically in error. Leptin resistance is not as much of an issue as it is portrayed. You have to lose weight accurately, without crash dieting to maintain your lean body mass, and if you lose it, you will spike your ghrelin and start the cycle of yo-yo dieting. Under eating, over exercising, and starvation can all cause this negative release of the hormone ghrelin.

You need to have elevated ghrelin when losing weight to inhibit the release of insulin, and spike the release of glucagon. If your leptin remains high, and in obese people, it is, you will have elevated insulin, estrogen, and other weight storing hormones.

Do not worry about leptin resistance, because with effective weight loss, your leptin levels plummet and your metabolism will not fall into the trenches. You will maintain your energy levels, and as the weight comes off you will even see an improvement.

Stay Tuned for more on the rest of the hormones involved in this ever so complex concept, and remember, health is not a destination, it is a journey.

Dr. Moz

If you are tired of seeking pain relief with no results, call (812) 799-0668 TODAY and schedule a FREE CONSULTATION, and let's get you back to the PAIN-FREE Life you are missing.

Visit TODAY!

1.       Myers MG, Jr., Munzberg H, Leinninger GM, Leshan RL. The geometry of leptin action in the brain more complicated than a simple ARC. Cell Metab 2009;9:117-23.
2.       Schwartz MW, Woods SC, Porte D, Jr., Seeley RJ, Baskin DG. Central nervous system control of food intake. Nature 2000;404:661-71.
3.       Rosenbaum M, Leibel RL. The role of leptin in human physiology. N Engl J Med 1999;341:913-5.
4.       Ahima RS, Saper CB, Flier JS, Elmquist JK. Leptin regulation of neuroendocrine systems. Front Neuroendocrinol 2000;21:263-307.
5.       Emilsson V, Liu YL, Cawthorne MA, Morton NM, Davenport M. Expression of the functional leptin receptor mRNA in pancreatic islets and direct inhibitory action of leptin on insulin secretion. Diabetes 1997;46:313-6.
6.       Morioka T, Asilmaz E, Hu J, Dishinger JF, Kurpad AJ, Elias CF, et al. Disruption of leptin receptor expression in the pancreas directly affects beta cell growth and function in mice. J Clin Invest 2007;117:2860-8.
7.       Wang MY, Lee Y, Unger RH. Novel form of lipolysis induced by leptin. J Biol Chem 1999;274:17541-4.
8.       Jiang L, Wang Q, Yu Y, Zhao F, Huang P, Zeng R, et al. Leptin contributes to the adaptive responses of mice to high-fat diet intake through suppressing the lipogenic pathway. PLoS One 2009;4:e6884.
9.       Minokoshi Y, Kim YB, Peroni OD, Fryer LG, Muller C, Carling D, et al. Leptin stimulates fatty-acid oxidation by activating AMP-activated protein kinase. Nature 2002;415:339-43.
10.   Myers MG, Jr., Leibel RL, Seeley RJ, Schwartz MW. Obesity and leptin resistance: distinguishing cause from effect. Trends Endocrinol Metab 2010;21:643-51.
11.   Zabolotny JM, Bence-Hanulec KK, Stricker-Krongrad A, Haj F, Wang Y, Minokoshi Y, et al. PTP1B regulates leptin signal transduction in vivo. Dev Cell 2002;2:489-95.
12.   Bjorbak C, Lavery HJ, Bates SH, Olson RK, Davis SM, Flier JS, et al. SOCS3 mediates feedback inhibition of the leptin receptor via Tyr985. J Biol Chem 2000;275:40649-57.
13.   Bjorbaek C, Elmquist JK, Frantz JD, Shoelson SE, Flier JS. Identification of SOCS-3 as a potential mediator of central leptin resistance. Mol Cell 1998;1:619-25.
14.   Loffreda S, Yang SQ, Lin HZ, Karp CL, Brengman ML, Wang DJ, et al. Leptin regulates proinflammatory immune responses. FASEB J 1998;12:57-65.
15.   Bjorbaek C, Kahn BB. Leptin signaling in the central nervous system and the periphery. Recent Prog Horm Res 2004;59:305-31.
16.   Ahima RS, Flier JS. Adipose tissue as an endocrine organ. Trends Endocrinol Metab 2000;11:327-32.
17.   Mullington JM, Chan JL, Van Dongen HP, Szuba MP, Samaras J, Price NJ, et al. Sleep loss reduces diurnal rhythm amplitude of leptin in healthy men. J Neuroendocrinol 2003;15:851-4.
18.   Spiegel K, Leproult R, L'hermite-Baleriaux M, Copinschi G, Penev PD, Van CE. Leptin levels are dependent on sleep duration: relationships with sympathovagal balance, carbohydrate regulation, cortisol, and thyrotropin. J Clin Endocrinol Metab 2004;89:5762-71.
19.   Taheri S, Lin L, Austin D, Young T, Mignot E. Short sleep duration is associated with reduced leptin, elevated ghrelin, and increased body mass index. PLoS Med 2004;1:e62.
20.   Vgontzas AN, Papanicolaou DA, Bixler EO, Lotsikas A, Zachman K, Kales A, et al. Circadian interleukin-6 secretion and quantity and depth of sleep. J Clin Endocrinol Metab 1999;84:2603-7.
21.   Vgontzas AN, Zoumakis E, Bixler EO, Lin HM, Follett H, Kales A, et al. Adverse effects of modest sleep restriction on sleepiness, performance, and inflammatory cytokines. J Clin Endocrinol Metab 2004;89:2119-26.
22.   Campo A, Fruhbeck G, Zulueta JJ, Iriarte J, Seijo LM, Alcaide AB, et al. Hyperleptinaemia, respiratory drive and hypercapnic response in obese patients. Eur Respir J 2007;30:223-31.
23.   O'donnell CP, Schaub CD, Haines AS, Berkowitz DE, Tankersley CG, Schwartz AR, et al. Leptin prevents respiratory depression in obesity. Am J Respir Crit Care Med 1999;159:1477-84.
24.   Nobre JL, Lisboa PC, Santos-Silva AP, Lima NS, Manhaes AC, Nogueira-Neto JF, et al. Calcium supplementation reverts central adiposity, leptin, and insulin resistance in adult offspring programed by neonatal nicotine exposure. J Endocrinol 2011;210:349-59.
25.   Zemel MB. The role of dairy foods in weight management. J Am Coll Nutr 2005;24:537S-46S.
26.   Nonaka H, Tsujino T, Watari Y, Emoto N, Yokoyama M. Taurine prevents the decrease in expression and secretion of extracellular superoxide dismutase induced by homocysteine: amelioration of homocysteine-induced endoplasmic reticulum stress by taurine. Circulation 2001;104:1165-70.
27.   Gentile CL, Nivala AM, Gonzales JC, Pfaffenbach KT, Wang D, Wei Y, et al. Experimental evidence for therapeutic potential of taurine in the treatment of nonalcoholic fatty liver disease. Am J Physiol Regul Integr Comp Physiol 2011;301:R1710-R1722.
28.   Haber CA, Lam TK, Yu Z, Gupta N, Goh T, Bogdanovic E, et al. N-acetylcysteine and taurine prevent hyperglycemia-induced insulin resistance in vivo: possible role of oxidative stress. Am J Physiol Endocrinol Metab 2003;285:E744-E753.

29.   Crujeiras AB, Goyenechea E, Abete I, Lage M, Carreira MC, Martínez JA, Casanueva FF. Weight regain after a diet-induced loss is predicted by higher baseline leptin and lower ghrelin plasma levels. J Clin Endocrinol Metab. 2010 Nov;95(11):5037-44. Epub 2010 Aug 18.